Is there a maximum dose of ondansetron that can be given via IV push?

Comment by InpharmD Researcher

There is no maximum recommended dose of ondansetron to be given as IV push. The use of a high-dose IV ondansetron push is primarily described in case reports which detail the patient’s experience with seizures and extrapyramidal reactions possibly developed by ondansetron administration. One study administered ondansetron 16 mg over 1 minute (Table 2); however, it remains uncertain whether a high-dose IV push of ondansetron is safe. It is generally recommended for ondansetron to be given over 2-5 minutes (not given in a push less than 30 seconds).

Background

The author of an editorial of a case series describing severe bradycardia and loss of consciousness following ondansetron administration states the original paper does not describe the rate at which ondansetron was given. It is not uncommon for residents to administer ondansetron as a bolus perioperatively, but the author wants clinicians to be aware that ondansetron 4 to 8 mg IV should be administered over 2 to 5 min and not as a bolus or in less than 30 seconds. Instead, the editorial recommends ondansetron over 2 to 5 minutes to decrease the incidence of potentially life-threatening adverse effects. [1]

A case study from 2001 described the experience of a 55-year-old woman with metastatic breast cancer who was administered 8 mg dexamethasone and 8 mg ondansetron IV push as an antiemetic during chemotherapy. The patient had no history of seizures or heart disease. On the day following administration of ondansetron and dexamethasone, the patient developed tonic-clonic seizures, which lasted for a duration of two minutes. The suspected underlying reason was considered to be brain metastasis or metabolic abnormality, but a definite cause was not established and the patient was discharged. The patient developed seizures once again; a detailed exam found no apparent abnormalities. Due to persistent vomiting, ondansetron was changed to metoclopramide, resulting in a resolution of vomiting. The patient's health care providers suspected seizures may have been an adverse event of a drug, possibly ondansetron. Following the discontinuation of ondansetron, no further seizures were reported. Thus, the authors believed ondansetron was the likely cause. [2]

Another case report was cited within a randomized trial. A 65-year-old woman with nasopharyngeal carcinoma received an IV push of 8 mg (0.15 mg/kg) of undiluted ondansetron and 20 mg IV dexamethasone on day one of chemotherapy. Ondansetron IV push was administered prior to the initial cisplatin dose. Following this, the patient received ondansetron 8 mg orally at 8-hour intervals for four days. This same routine appears to have been followed for the second cycle. However, for the third cycle, on the third day, the seventh dose of ondansetron was slowly injected intravenously. The patient subsequently developed dystonia of the jaw, stiffness of the limbs, inability to speak, anxiety, and a burning sensation in the face and hands. The episode lasted 1-2 minutes and resolved spontaneously. The subsequent doses of ondansetron, for the rest of the third cycle and for the fourth cycle were administered diluted over a 15-min intravenous infusion, with no additional adverse events. The authors suspected a correlation between direct IV ondansetron administration and the occurrence of the aforementioned adverse events, suggesting a possible relation between the effects and high plasma levels of the drug. [3], [4]

A prospective cohort study (N= 261) assessed the effects of ondansetron on cardiac safety in children and pregnant women. Patients were divided into three cohorts: pediatric oncology (n= 98), pregnant women (n= 62), and pediatric surgery (n= 101). Of these three, only pregnant women were permitted to receive 4-8 mg ondansetron. The route of administration is not clearly defined. It appears IV push was permitted, but patient characteristics list that nearly 100% of patients received an IV bolus, substantially limiting the conclusions that may be derived from this study regarding the safety of a high dose ondansetron IV push. The authors concluded that, although rare, ondansetron may be associated with transient QT prolongation. No associations between clinical variables and the incidence of QT prolongation were observed within individual cohorts. [4]

References:

[1] Prakash S, Aggarwal M. Rate of administration of intravenous ondansetron. Indian J Anaesth. 2011;55(4):426-427. doi:10.4103/0019-5049.84827
[2] Sharma A, Raina V. Generalised seizures following ondansetron. Ann Oncol. 2001;12(1):131-132. doi:10.1023/a:1008394422101
[3] Sandoval C, Corbi D, Strobino B, Fevzi Ozkaynak M, Tugal O, Jayabose S. Randomized double-blind comparison of single high-dose ondansetron and multiple standard-dose ondansetron in chemotherapy-naive pediatric oncology patients. Cancer Invest. 1999;17(5):309-313. doi:10.3109/07357909909032871
[4] Garcia-del-Muro X, Cardenal F, Ferrer P. Extrapyramidal reaction associated with ondansetron. Eur J Cancer. 1993;29A(2):288. doi:10.1016/0959-8049(93)90199-p
[5] Drögemöller BI, Wright GEB, Trueman J, et al. A pharmacogenomic investigation of the cardiac safety profile of ondansetron in children and pregnant women [published online ahead of print, 2022 Feb 8]. Biomed Pharmacother. 2022;148:112684. doi:10.1016/j.biopha.2022.112684

Relevant Prescribing Information

The recommended adult intravenous dosage of ondansetron is 4 mg undiluted administered intravenously in not less than 30 seconds, preferably over 2 to 5 minutes, immediately before induction of anesthesia, or postoperatively if the patient did not receive prophylactic antiemetics and experiences nausea and/or vomiting occurring within 2 hours after surgery. [6]

References:

[6] Ondansetron [prescribing information]. Lake Zurich, IL: Fresenius Kabi; 2019.

Literature Review

A search of the published medical literature revealed 2 studies investigating the researchable question:

Is there a maximum recommended dose of ondansetron that should be given as IV push for CINV or for PONV?

Level of evidence

C - Multiple studies with limitations or conflicting results  Read more→



Please see Tables 1-2 for your response.


 

Cardiovascular stability with rapid intravenous infusion of ondansetron

Design

Randomized, blinded, placebo-controlled study

N=71

Objective

To determine the effects of rapid IV administration of ondansetron on heart rate, blood pressure, respiratory rate and oxygen saturation in patients about to undergo general anesthesia

Study Groups

Placebo (n=18)

Ondansetron 1 mg (n=18)

Ondansetron 4 mg (n=16)

Ondansetron 8 mg (n=19)

Inclusion Criteria

Female, ASA I or II, aged 20-62 years old, scheduled for surgery requiring general endotracheal anesthesia

Exclusion Criteria

None described

Methods

Patients were randomly assigned to receive 20 mL of a solution that contained 0, 1, 4, or 8 mg of ondansetron infused over 2 minutes.

Duration

Until end of operation

Outcome Measures

Heart rate, blood pressure, respiratory rate

Baseline Characteristics

 

Placebo (n=18)

Ondansetron 1 mg (n=18)

Ondansetron 4 mg (n=16)

Ondansetron 8 mg (n=19)

Age, years

36 ± 9 34 ± 6 36 ± 10 33 ± 10

Weight, kg

63 ± 9 64 ± 9 67 ± 16 67 ± 12

Results

 

Placebo (n=18)

Ondansetron 1 mg (n=18)

Ondansetron 4 mg (n=16)

Ondansetron 8 mg (n=19)

Heart rate, bpm

Infusion start

Infusion end

 

77 ± 13

77 ± 12

 

80 ± 12

77 ± 11

 

75 ± 10

74 ± 10

 

74 ± 12

75 ± 13

Blood pressure, mm Hg

Infusion start

Infusion end

 

128/79

128/79

 

129/79

125/76

 

126/72

126/72

 

130/79

129/77

Respiratory rate, bpm

Infusion start

Infusion end

 

18 ± 2

18 ± 2 

 

18 ± 2

18 ± 2

 

18 ± 2

18 ± 2

 

17 ± 2

18 ± 2

There were no clinically or statistically significant changes in heart rate during the five-minute period following administration of placebo or ondansetron at any dose.

Adverse Events

None reported

Study Author Conclusions

Heart rate, blood pressure, respiratory rate, and oxygen saturation were not acutely affected by rapid IV administration of ondansetron in healthy patients.

InpharmD Researcher Critique

This study only included healthy, awake female patients undergoing laparoscopic surgery, which may limit the generalizability of the results. Intraoperative and postoperative data were not collected.



References:

Heyman JS, Young ML, Bagshaw RJ, et al. Cardiovascular stability with rapid intravenous infusion of ondansetron. Can J Anaesth. 1993;40(5 Pt 1):448-52.

 

Intravenous ondansetron for the control of opioid-induced nausea and vomiting

Design

Randomized, double-blind, double-masked, placebo-controlled trial

N=520

Objective

To assess the safety and efficacy of 2 doses of intravenous ondansetron (8 and 16 mg) for the control of opioid-induced nausea and vomiting

Study Groups

Placebo (n=94)

Ondansetron 8 mg (n=215)

Ondansetron 16 mg (n=211)

Inclusion Criteria

Male or non-pregnant, non-lactating females, aged ≥12 years, acute pain or exacerbation of chronic pain requiring opioid analgesia

Exclusion Criteria

Severe illness or other causes of nausea and vomiting; had undergone surgery, chemotherapy, or total or lower body radiation within the previous 5 days; scheduled to undergo such procedures during the study

Methods

Patients who developed nausea or vomiting were randomized 2:5:5 to receive a single IV dose of placebo (saline), ondansetron 8 mg (1 mg/mL), or ondansetron 16 mg (2 mg/mL) over 1 minute.

Duration

Follow-up: up to 24 hours after receipt of the study drug

Outcome Measures

Complete emesis control (no emetic episodes)

Baseline Characteristics

 

All patients (N=520)

Age, years

40.6 ± 15.0

Female

317 (60.0%)

Weight, kg

77.1 ± 21.1

White

351 (67.5%)

Nausea/vomiting with prior opioid use

220/364 (60.4%)

Results

 

Placebo (n=94)

Ondansetron 8 mg (n=215)

Ondansetron 16 mg (n=211)

Complete emesis control

43 (45.7%) 134 (62.3%) 145 (68.7%)

Adverse Events

Headache (3% vs 5% vs 6%), dizziness (2% vs 1% vs 2%)

No other adverse event occurred in >2% of patients in any treatment group

Study Author Conclusions

The results of this study demonstrate that intravenous ondansetron in doses of 8 or 16 mg over 1 minute is an effective antiemetic agent for the control of opioid-induced nausea and vomiting in nonsurgical patients requiring opioid analgesia for pain.

InpharmD Researcher Critique

This study did well to include patients who experienced nausea/vomiting with opioid use, and strict entry criteria attempted to remove confounding variables as surgery, chemotherapy, radiotherapy, and antiemetic medications.

Many of the centers conducting the study in an emergency department setting did not have dedicated study personnel available at all times to screen or monitor study patients, and many potential study participants were thus missed.



References:

Sussman G, Shurman J, Creed MR, et al. Intravenous ondansetron for the control of opioid-induced nausea and vomiting. International S3AA3013 Study Group. Clin Ther. 1999;21(7):1216-27.